Breathlessness

• Respiratory infections
• Diseased lungs, due to lung cancer or mesothelioma, for example
• Damaged lungs, due to radiotherapy, chemotherapy or other drug therapies, for example
• Removal of some lung tissue, surgery for lung cancer, for example 
• Inflammation of your lungs
• Infection
• Fluid around your lungs (pleural effusion)
• Fluid in your abdomen (ascites)
• Lung clots
• Anaemia

Other causes include panic or anxiety, lack of physical fitness, being overweight, emphysema/COPD, thyroid problems, heart conditions, muscle weakness and smoking.

Bleomycin and breathlessness

In rare cases, the drug bleomycin may cause inflammation of the lungs. This can lead to shortness of breath. Your doctors will check your lungs before, during and after treatment. If you notice a change in your breathing, tell your doctor as soon as possible. They may stop or reduce the amount of the medication. Not smoking will help to reduce the risk of this happening to you. 

If you are a scuba diver, talk to your doctor about any possible risks of this associated with bleomycin treatment. If you need an anaesthetic for an operation after having had bleomycin, make sure you tell your anaesthetist you've had the treatment.

The symptoms of breathlessness vary from person to person and can range from mild to severe. Sometimes it may not be visible to the person looking at you. You may experience:

• Difficulty catching your breath
• Noisy breathing
• Fast, shallow breathing
• Wheezing
• Chest pain

Other symptoms include:

• Pale or blue skin, especially around your mouth
• Increase in your pulse rate
• Cold or clammy skin
• Flared nostrils when you breathe in
• Feeling anxious
• Using your shoulders and chest to breathe in

Shortness of breath (dyspnoea) can be very uncomfortable and distressing. Tell your doctor if you feel breathless, so they can find out the cause of your breathlessness and help to treat it. 

You may need some of the following tests to investigate the cause of your breathlessness:

Treatment depends on what’s causing the problem.  

• Ask the hospital physiotherapist or nurse to show you some breathing exercises that will help to strengthen your muscles used in breathing. Follow any exercise plan they recommend.
• The physiotherapist can also show you ways to sit that will increase the amount of air you can take into your body.
• You may find that you sleep better in a comfortable chair than in a bed.
• Avoid doing things that increase your shortness of breath, such as bending over and climbing flights of stairs. Take your time getting dressed and wear clothes and shoes that are easy to put on.
• Anxiety can make a breathing problem seem much worse, so a quiet setting can really help. Listen to relaxing music too. 

• If you are anxious and upset, ask to speak to a counsellor about your feelings – it may help.

  If you are feeling breathless or notice any change in your breathing, tell your doctor. It is important your doctor finds out the cause of your breathlessness. That way they can treat it properly. We also have advice on coping with an episode of breathlessness and what to do in an emergency.

There are many people who can help you to manage your breathlessness. These include the cancer liaison nurse, physiotherapist and occupational therapist. Some centres have special breathlessness clinics so your doctor can also refer you to one of these.

Your cancer doctor (oncologist) may refer you to the palliative care team to help you manage this symptom. These doctors and nurses specialise in controlling your symptoms and improving your quality of life. Breathlessness can be a very common complaint for many patients with cancer.